Abstract
IntroductionThere are many techiques describe for ureteroenteric anastomoses. We present our experience with three of them inorder to reduce the stenosis rate. Method and MaterialWe have done radical cystectomy in 77 patients. Urinary diversion with small bowel in 20 patients (Paduana ileal neobladder) and dstubulized ureterosigmoidostomy (MainzII) in 55. Initialy, we used Le Duc technique, afterward Ricard technique and actually bivalva technique (direct). ResultsWe have performed Le Duc in 38%, Ricard in 31% and "bivalva" in 27%. Median follow-up are 37,7 months, 19,9 months and 10 months respectivily. Stenosis: 16,7% with Le Duc; 20,5% with Ricard and 9,1% with bivalva technique. Renal anulation: 10,4% with Le Duc; 10,3% with Ricard and 0% with bivalva (p .000). ConclusionsIn our experience, the less stenosant anastomose is BivalvaIn one. The simpliest technique, the best results. The rate of stenosis is higher when the upper urinary tract is dilatated pre-surgery, independently of the anastomosis technique.
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